Answer: Paediatric Electrocardiogram for the week of Thursday December 7th 2006

Paediatric Electrocardiogram of the Week

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Answer for: December 7th
Sinus rhythm with complete AV block. Atrial rate 120 Ventricular rate 49.
QRS axis +60. QRS 60ms. QT/QTc 436/431
Left axis deviation
Left ventricular hypertrophy

Comment: December 7th 2006
At first glance this ECG appears to show sinus rhythm with 2:1 AV block. Careful measurement in several tracings reveals that there is complete AV dissociation with intermittent synchronous contraction of atrium and ventricle.
An alternative explanation of this particular tracing is atrial bigeminy with blocked PAC's.
The left axis deviation and left ventricular hypertrophy results from prolonged intrauterine complete AV block causing an increased LV stroke volume